Freiburg, Germany From the Department of Plastic and Hand Surgery, University Medical Center Freiburg and Erich Lexer Clinic, and the Institute of Medical Biometry and Medical Informatics, University of Freiburg.
Plast Reconstr Surg. 2012 Dec;130(6):830e-840e. doi: 10.1097/PRS.0b013e31826d9f37.
Although a multitude of proposed forehead rejuvenation procedures have been described, long-term and systematic morphometric evaluation is rare. There are no studies comparing endoscopic forehead lifts and transpalpebral browpexy techniques according to their efficacy in raising and reshaping the brow.
In a retrospective study, standardized photographic documentations of patients undergoing an endoscopic forehead lift or a transpalpebral browpexy were morphometrically analyzed. Five measurements were taken to evaluate brow height, and two measurements were taken to describe the change in brow shape.
Fifty-six and 29 patients, respectively, in the two groups were analyzed up to 5 years postoperatively. Morphometric evaluation proved a significant elevation of the total brow and an improvement in brow shape for the endoforehead group, whereas the brow position after the transpalpebral browpexy significantly descends, despite an improvement in subjective aesthetic outcome. An additional blepharoplasty after the endoscopic forehead lift does not lower the brow significantly.
The efficacy of the endoforehead lift is supported by extensive, systematic, and long-term data, and its superiority over transpalpebral approaches has been proven. The descent of the brow after transpalpebral browpexy is most likely caused by a decrease of frontalis hyperactivity after the simultaneously performed blepharoplasty. Further studies need to evaluate its effect compared with blepharoplasty alone.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
尽管已经描述了许多种用于额部年轻化的方法，但很少有长期和系统的形态学评估。目前尚无研究比较内窥镜额部提升术和经皮眉固定术根据其提眉和重塑眉形的效果。
在一项回顾性研究中，对接受内窥镜额部提升术或经皮眉固定术的患者进行了标准化的照片记录，并进行了形态学分析。共测量了 5 个指标来评估眉高，2 个指标来描述眉形的变化。
分别对两组中 56 例和 29 例患者进行了 5 年的术后随访。形态学评估证实，在经额部提升组中，总眉高度显著升高，眉形得到改善，而经皮眉固定组的眉位置明显下降，尽管患者的主观美学效果得到改善。在进行内窥镜额部提升术之后进行的额外的双眼皮手术并不会显著降低眉部位置。
广泛、系统和长期的数据支持内窥镜额部提升术的疗效，并且已经证明其优于经皮眉固定术。经皮眉固定术后眉部下降的原因可能是同时进行的双眼皮手术后额肌的过度活跃减少。需要进一步的研究来评估其与单纯双眼皮手术相比的效果。
临床问题/证据水平：治疗性，III 级。
